Healthcare Provider Details

I. General information

NPI: 1891893863
Provider Name (Legal Business Name): NAVEEN ACHARYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RIVERSIDE DR E STE 2010
BRADENTON FL
34208-1008
US

IV. Provider business mailing address

700 8TH AVE W STE 101
PALMETTO FL
34221-4737
US

V. Phone/Fax

Practice location:
  • Phone: 941-405-1170
  • Fax: 941-405-1175
Mailing address:
  • Phone: 941-776-4008
  • Fax: 941-845-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME101747
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: